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Portal thrombosis has been reported after laparoscopic surgery of the colon, spleen and gallbladder, but very infrequently after Nissen fundoplication, all having a favorable outcome Fatal portal thrombosis after laparoscopic Nissen fundoplication. nssen

However, the clinical incidence of portal thrombosis is minimal. This prevents the reflux of gastric acid in GERD. The Impact Factor measures the average number of citations received in a particular year by papers published in the funnduplicatura during the two receding years. En el control postoperatorio se realizaron: A funudplicatura floppy Nissen fundoplication was done with non-absorbable material after adapting the diaphragmatic crura behind the esophagus.

Lower esophageal sphincter pressure was 3 mmHg normal range, mmHg. The esophageal hiatus is also narrowed down by sutures to prevent or treat concurrent hiatal hernia, in which the fundus slides up through the enlarged esophageal hiatus of the diaphragm.

However, when its purpose is to reduce gastric reflux, difficulty in vomiting may be an undesired outcome. Intraoperative Doppler ultrasounds showed total thrombosis and air in the portal vein, as well as patent mesenteric and hepatic arteries.

Retrieved from ” https: Would a different regimen have diminished the severity of the clinical picture? Intraoperative complications occurred in 11 patients and the rate of conversion to open surgery was 1.

Reflux esophagitis, sliding hiatal hernia, and the anatomy of repair. The onset of the portal thrombosis clinical picture may vary from insidious, consisting of funduplivatura pain with scanty physical findings, to one of sudden onset with fever, tachycardia and hypotension, later evolving to a shock, as was the case with our patient.

Two cases also showed additional predisposing conditions to thrombosis: Cir Esp, 59pp. The first hour of postoperative period was uneventful, and the patient was discharged asymptomatic. Fundupliatura Laparosc Endosc, 1pp. Nissen fundoplication Diagram of a Nissen fundoplication. Are you a health professional able to prescribe or dispense drugs?

Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. Nissenn the symptoms warrant a repeat surgery, the surgeon may use Marlex or another form of artificial mesh to strengthen the connection. Manometry revealed a mean basal EEI pressure of High pressure causes collapse and, therefore, blood flow resistance increases 2. Hypovolemic, hemorrhagic shock due to portal and mesenteric thrombosis was established as the cause of death.

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Symptom onset happened after abundant food ingestion in one case 2 and after food and gassy drink ingestion in our case. The American Journal of Digestive Diseases.

Comparison of outcomes of open versus laparoscopic Nissen fundoplication performed in a single practice. The aim of this study was to determine, through our results and comparison of pre- and postoperative manometric and pH monitoring data, whether Nissen fundoplication is the technique of choice in the treatment of gastroesophageal reflux disease GERD and whether it provides similar results to those of conventional surgery.

Outcomes have improved in recent years, especially at the most skilled and successful clinics [ citation needed ]. We thus believe that there may be another factor playing a central role in its pathogenesis. N Engl J Med,pp. Also, hypercapnia due to CO2 absorption brings about a decrease in mesenteric blood flow as a result of vasoconstriction.

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Nissen fundoplication

Min Chir, 38pp. Preoperative studies included esophagogastroduodenoscopy, TEGD, hour pH monitoring and esophageal manometry. All patients presented symptomatology of GERD with a mean evolution of 5 years and all had received appropriate medical therapy for niwsen mean of 24 months.